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People are apparently clamouring for a health system funded by insurance so...

182 replies

Hanschenklein · 10/01/2023 18:03

Those MNetters in countries outside the UK how much do you pay a month for your health care ? Is your country's system completely financed by this insurance alone or does your government contribute too ?
People call the NHS a financial black hole. They resent the fact that ever increasing amounts of money are apparently being ploughed into the service to see no real improvement. They seem happy to pay via an insurance style system instead.
So how much do you and your family pay ? How do you contribute towards your pension in the absence of national insurance payments ? If you pay a fee to see a GP does that put you off going ? Do you struggle to pay this insurance if not well paid ?
Most importantly is your health service sufficiently staffed, safe and prompt ? Are HCPs in your country valued, well paid and happy in their jobs ?

OP posts:
Chewbecca · 10/01/2023 22:06

You’d be crazy to want to remove ‘free’ healthcare in the UK.

I have private insurance with work and am currently leaving. My quote to continue cover (for me only, more than double it to include DH) is £350pm. It’s the only way I can get insurance that covers my pre existing conditions. It’s outrageous.

Chesthairlikekingkong · 10/01/2023 22:07

Who would pay the £175,000 per year for a medium secure psychiatric bed for someone with long term schizophrenia? In fact what provision is there for any long term mental health conditions in private health care, particularly when the patient is incapable of work?

HereForTheFreeLunch · 10/01/2023 22:11

Who's "clamouring"? Rees-Mogg, Sunak and Truss?

Interested in this thread?

Then you might like threads about these subjects:

LexMitior · 10/01/2023 22:11

@Kendodd - yes perhaps we should have a referendum based on the future of the NHS...

We could have a bus. Perhaps Boris can stand next to and it says "30 pence a week for your comprehensive medical insurance"

I reckon it's a winner

scoobelopey · 10/01/2023 22:13

I just don't understand how moving to any other system will change the fundamental issues in how the health service is delivered in the U.K.?

There are no untapped medical buildings, infrastructure, staff or equipment that isn't already used. To get a service that is worthy of people happily paying privately to access, you'd have to invest HUGE amounts of money (almost all hospitals need rebuilding and masses of staff going through training) and be years in the making.

In the meantime you'd be asking people to pay privately to access the exact same service they are receiving now.....🤷‍♀️

katepilar · 10/01/2023 22:13

katepilar · 10/01/2023 21:58

In my country you pay 13.5% for health insurance of your gross pay and your employer pays another 9% of your gross pay. all health care is free, the only staff we pay for are fillings, unless you have a very basic amalgam ones.
The doctors and nurses can be sometimes rude and patronising but the actual treatment is usually very good.
Post-communist country.

Children, students, old people, pregnant women and unemployed /for limited amout of time/ get the insurance paid by the government. Apart from these it mandatory to pay.
For some medication you need to /partially/pay.
Medical care includes dentists, opticians, physio, hospital stays. and A&E /where you need to pay a small fee/, including emergency dental services.

scoobelopey · 10/01/2023 22:17

I also don't get how you practically bring insurance in.

Fine if you have it at birth before any issues arise but how does the 75yo who has recovered from cancer and has heart disease in their history get affordable insurance that covers them needed hip operation? How does a known T1 diabetic get coverage for insulin, check ups, podiatry reviews. How does a child needing a heart transplant get insurance for one??!

Where else in the world has swapped from a system like ours to an insurance based one? How does it work during a transition? Do many people just not qualify for insurance?

Chesthairlikekingkong · 10/01/2023 22:19

@scoobelopey I also wonder about these points.

paintitallover · 10/01/2023 22:22

I don't think anyone is clamouring for that. It's a shit system, which is why so many Americans don't get healthcare. Remember Obamacare, and it's reversal by Trump? Don't be fooled by the rhetoric.

WeBuiltThisBuffetOnSausageRoll · 10/01/2023 22:23

I hope not, I'd never get insurance with pre-existing conditions. And I can't work because of them, so couldn't afford it anyway. Basically I'd be fucked.

Yes, same here. Same also with life insurance, which everybody urges you that you simply must have, if you want your children to be protected, but has no answer for you (or your children) when you cannot get it or, if you can (probably excluding death that could possibly in any way be attributed to existing conditions, so not that much use anyway), the premiums will be more than you earn each month.

As has been said, insurers run their businesses for profit. Just like a supermarket would stop offering less popular lines that cost them more in shelf space than the few sales make them, commercial insurance companies do not want the people who need them most.

People like us are just 'other' - we like to think that our lives are as important as everybody else's, but we're just a statistical aberration that can be swept under the carpet and ignored as irrelevant.

WeBuiltThisBuffetOnSausageRoll · 10/01/2023 22:26

Also, like with prescriptions in the UK, a lot of suggestions are 'you just pay a small fee on the occasions when you need something' - with no consideration given to those who would end up paying a regular mountain of 'small fees', often those least able to earn to pay them at all in the first place.

FlowerArranger · 10/01/2023 22:27

If anyone is interested in people's experiences of access private health-care in the UK, YOU AND YOURS covered this today (Radio 4 on BBC Sound)

WeBuiltThisBuffetOnSausageRoll · 10/01/2023 22:28

Thanks, FlowerArranger - will have a listen to that.

LexMitior · 10/01/2023 22:29

Well I've used my own in the past. Three months treatment. Base cost, 45k. Outpatient and drugs extra.

Btw, that is quite cheap compared to the US.

FlowerArranger · 10/01/2023 22:30

A study in the Annals of Internal Medicine found that in 2021, nearly 1 in 5 adults in the U.S. with diabetes either skipped, delayed or used less insulin than was needed to save money. That comes out to roughly 1.3 million adults, or 16.5% of those who need insulin.

www.nbcnews.com/health/health-news/insulin-prices-many-adults-diabetes-ration-insulin-study-finds-rcna52287

BertieBotts · 10/01/2023 22:32

I live in Germany. No idea how much we pay for health insurance, it's taken out of salary before we see it. DH's insurance covers me and all the children including DS1 who isn't biologically or legally his. I think it's a percentage of salary, rather than a set amount. You can probably look this up. I know that whatever we pay is matched by the employer. This is the same for unemployment insurance, pension insurance (contribution to state pension) and long term sickness insurance. These all replace national insurance I believe.

In general I like the system here and am very happy with it. The quality of care is excellent and you can generally get everything you need. There is some duplication that doesn't seem very efficient, for example in the UK when I've needed an ultrasound I've been sent to the hospital and they have been carefully rationed as though a scarce resource. Here I had one every single appointment in all my pregnancies, including a 3D one. My gynaecologist has two machines in her office. There are several in the maternity suite at the hospital, probably other places too. GPs have one - I had one when I had persistent kidney pain and one for a thyroid check up. DH went to a urologist and he had at least one. This is great for me as a patient but thinking of the overall cost for all those machines and everyone to be trained to use them.

I always feel here that doctors have time for you. I don't feel rushed and once you're in with a doctor then you can generally have as many appointments as you like. The idea of being offered six sessions of counselling would be strange here - the treatment continues until it's no longer needed.

My main gripe is the decentralised nature of the system. It's left up to the patient to do all the admin of locating a specialist and making an appointment, you just get a referral. But whether it's because I'm a foreigner or it's just hard in general, I find it baffling that nobody will assign me a person to see. I have to research myself who is available, there aren't any central lists either so I'm using Google maps or doctor listing websites that are often out of date. For example I'm trying to sort out ADHD medication at the moment. I made a list of 12 likely sounding options, but many of them don't have a website and don't say what exactly they do on their listing so four of them didn't offer medication, only therapy, or only treat children. Three were chronically engaged. Three I had to listen to a crackly and complicated recorded message explaining their phone times which are something ridiculous like 2 hours a week. (Most do at least take phone calls in the mornings every day!) When you do get through to somebody often they aren't taking new patients, or they only accept private self payers. Or they can't see you for weeks and weeks. By the way, this is also for emergencies like broken bones. DH broke his foot and I had to phone around MRI and x-ray places. It took six weeks by this time it was too late to operate. When we went back to the hospital they said oh, you should have come back to us. But nobody explained this... I thought this was a one off but then a friend broke her elbow and had a similar experience. There's nobody to go back to and say hey this is urgent, can you get me a faster appointment? And if you get overwhelmed and give up, nobody follows up. I buggered up my finger and never finished the physio and it's probably too late now.

In terms of paying, we pay for prescriptions although insurance sometimes covers part of the cost. Children's prescriptions are free. You are sometimes upsold services such as an extra eye test at the paediatrician or some gynaecologists give you basic scans free and charge a flat rate for the extra ones. Extra testing in pregnancy is payable like on the NHS. Glasses aren't covered. Basic dentistry is covered but things like a scale and polish aren't. You can buy dental or glasses insurance separately. Physio therapy or massages usually have a copay of about €30. An ambulance costs €10 and sometimes a night in hospital has a nominal fee, but I wasn't charged when my children were born. You often have to pay towards medical equipment like insoles or physio devices but insurance pays most of the cost.

Insurance covers days that you take off work to look after sick children, I like this a lot. There are also lots of surprising things covered by insurance like a helper person to come to your house and help with childcare, cooking, cleaning if you are temporarily incapacitated and have children or a sick child with other children to care for, or after a multiple birth.

Conditions in hospital with children are great. When I've been in with the children you get a room with max 1 other person - even in NICU it was like that. The food is okay and parents get proper beds. The birth was a bit more medical and annoying, they insisted on monitoring me in case I ran out of oxygen when on gas and air 😆 but I didn't have to wait long for an anaesthetist if I wanted an epidural. They even provided clothing and nappies and stuff for the babies!

Overall I like it but I think the NHS could do a lot of this with better funding and organisation and less pressure from lacking social care. Although there is some improvement from competition between providers often there is no choice anyway as only one doctor in the whole city will have space for new patients. And the decentralisation can be a pain.

3luckystars · 10/01/2023 22:33

I pay €60 to see a GP but it will be the same day appointment.

I pay €100 per month private medical insurance. This is optional and lots of people do not have this.

it costs €150 to go to A&E. if you have a letter from the GP, this fee is waived. If you are admitted, this fee is waived also.

I also pay a lot of tax and I don’t know where that goes.

(Ireland)

blackpearwhitelilies · 10/01/2023 22:35

I haven’t heard anyone clamouring to go for insurance-based healthcare rather than the NHS. In fact, the reverse.

Mischance · 10/01/2023 22:41

I am interested in who actually pays the medics, nurses etc. in these systems where you pay a percentage of salary per month. Is it the government?

And do they have our fragmented system where different bits of the service are farmed out to private companies? Any attempt to introduce such systems here would be chaos unless we can have a cohesive service.

WeBuiltThisBuffetOnSausageRoll · 10/01/2023 22:42

I live in Germany. No idea how much we pay for health insurance, it's taken out of salary before we see it.

But how does that really differ from what the NHS could and should be, in principle? Just because successive governments have decided to defraud the fund by dipping into it instead of ringfencing it, that doesn't make the system itself a bad one.

MarshaBradyo · 10/01/2023 22:42

3luckystars · 10/01/2023 22:33

I pay €60 to see a GP but it will be the same day appointment.

I pay €100 per month private medical insurance. This is optional and lots of people do not have this.

it costs €150 to go to A&E. if you have a letter from the GP, this fee is waived. If you are admitted, this fee is waived also.

I also pay a lot of tax and I don’t know where that goes.

(Ireland)

We have private but have found NHS better for same day appointments recently

Private 48 to 72 hrs

BertieBotts · 10/01/2023 22:44

Just looked up the percentage in Germany and it's about 7% of gross pay, up to a maximum of about 2k per month. No minimum, but if you earn less than €525 a month then you don't pay social insurances anyway.

You can pay less for private health insurance but it's better to stay in the public system.

BertieBotts · 10/01/2023 22:45

WeBuiltThisBuffetOnSausageRoll · 10/01/2023 22:42

I live in Germany. No idea how much we pay for health insurance, it's taken out of salary before we see it.

But how does that really differ from what the NHS could and should be, in principle? Just because successive governments have decided to defraud the fund by dipping into it instead of ringfencing it, that doesn't make the system itself a bad one.

I like the NHS as a system, I don't think it's bad. But it is currently not performing very well.

blondieminx · 10/01/2023 22:46

roarfeckingroarr · 10/01/2023 22:02

@blondieminx yes but most people aren't net contributors and clearly it isn't working

You know what isn’t working?

Govt failing to keep health spending per capita in line with other developed countries. Systemically demoralising NHS staff (failing to recruit, retain and train enough staff after the Safe Staffing review, doctors pensions, removal of the nursing bursary in 2017, only for a pathetic gesture to be put in place after uproar - won’t cover accommodation let alone anything else… and myriad other instances of fuck around and find out.)

The NHS is precious and it’s OURS.

Nagado · 10/01/2023 22:49

blackpearwhitelilies · 10/01/2023 22:35

I haven’t heard anyone clamouring to go for insurance-based healthcare rather than the NHS. In fact, the reverse.

Me neither. Who are these people? I’ve never seen or heard anyone say anything other than they want an NHS that is fit for purpose.

OP, have you just made this claim up?